Active NPI
Jonathan M Goldstein, M.D.
- Neurology Physician
- New York, NY
National Provider Identifier
1821071192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 270535
- Practice address
- 535 E 70TH St
Department of Neurology
New York, NY 10021-4823 - Phone
- (212) 606-1046
- Fax
- (212) 249-9185
- NPI assigned
- Nov 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 030692 | CT | |
| Neurology Physician | 2084N0400X | 270535 | NY | Primary |
| Neuromuscular Medicine (Psychiatry & Neurology) Physician | 2084N0008X | 270535 | NY |
Addresses
Primary practice location
535 E 70TH St
Department of Neurology
New York, NY 10021-4823
Mailing address
PO Box 29234
New York, NY 10087-9234
Phone (631) 329-6925
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01556216 | Medicaid | NY | |
| 001306928 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030692 | CT | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middlesex Hospital | Current | Accepting new patients | |
| Middlesex Hospital | Neurology | Current | Accepting new patients |
| Gaylord Hospital, Inc. | Past | Accepting new patients |
Locations
534 Saybrook Rd
Middletown, CT 06457
Phone (860) 358-2500
80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878
28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000
Interoperability endpoints
- jgoldstein81392@middlesexhealthprd.direct-ci.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community Based Hospice Care Agency
- Middletown, CT
- NPI 1003873233
-
- Long Term Care Hospital
- Wallingford, CT
- NPI 1730137753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1821071192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29234",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100879234",
"telephone_number": "631-329-6925",
"fax_number": "631-329-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 E 70TH ST",
"address_2": "DEPARTMENT OF NEUROLOGY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214823",
"telephone_number": "212-606-1046",
"fax_number": "212-249-9185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDSTEIN",
"first_name": "JONATHAN",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CT",
"license": "030692",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "270535",
"primary": true
},
{
"code": "2084N0008X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neuromuscular Medicine",
"state": "NY",
"license": "270535",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01556216",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001306928",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.